Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $594.00 / $1,678.51 / $4,746.70	Facility		$594.00	$1,678.51	$4,746.70
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.72 / $53.88 / $1,711.57	Facility	53	$19.72	$53.88	$1,711.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.31 / $191.53 / $499.27	Professional		$91.31	$191.53	$499.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.86 / $158.34 / $409.29	Professional		$151.86	$158.34	$409.29
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,253.94 / $1,717.35 / $16,320.49	Facility		$1,253.94	$1,717.35	$16,320.49
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $140.88 / $281.76 / $493.98	Professional		$140.88	$281.76	$493.98
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,344.69 / $3,159.00 / $14,886.03	Facility		$2,344.69	$3,159.00	$14,886.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $247.01 / $372.96 / $448.62	Professional		$247.01	$372.96	$448.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.56 / $168.56 / $168.56	Facility		$168.56	$168.56	$168.56
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.71 / $33.71 / $33.71	Facility	53	$33.71	$33.71	$33.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.17 / $206.92 / $427.15	Professional		$106.17	$206.92	$427.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.59 / $395.65 / $513.70	Professional		$118.59	$395.65	$513.70
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $533.24 / $1,552.54 / $2,786.88	Facility		$533.24	$1,552.54	$2,786.88
Highmark BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $1,268.16 / $1,268.16 / $1,268.16	Facility	53	$1,268.16	$1,268.16	$1,268.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.17 / $244.11 / $258.30	Professional		$100.17	$244.11	$258.30
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $928.04 / $1,637.01 / $8,524.62	Facility		$928.04	$1,637.01	$8,524.62
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $281.76 / $315.57 / $560.84	Professional		$281.76	$315.57	$560.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $278.77 / $1,741.00 / $4,211.00	Facility		$278.77	$1,741.00	$4,211.00
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $19.72 / $53.88 / $1,711.57	Facility	53	$19.72	$53.88	$1,711.57
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $93.01 / $218.89 / $596.20	Professional		$93.01	$218.89	$596.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $272.39 / $272.39 / $556.29	Professional		$272.39	$272.39	$556.29
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $168.56 / $168.56 / $168.56	Facility		$168.56	$168.56	$168.56
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $33.71 / $33.71 / $33.71	Facility	53	$33.71	$33.71	$33.71
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $106.17 / $207.61 / $429.53	Professional		$106.17	$207.61	$429.53
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $96.24 / $111.82 / $260.62	Facility		$96.24	$111.82	$260.62
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $96.24 / $245.21 / $268.36	Professional		$96.24	$245.21	$268.36
United Facility/Professional Facility Modifier Low / Median / High Price $471.00 / $1,305.00 / $3,742.00	Facility		$471.00	$1,305.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $250.76 / $327.19 / $495.09	Professional		$250.76	$327.19	$495.09